Recruitment Methods, Inclusion, and Successful Participation in a Longitudinal Clinical Trial Using Ecological Momentary Assessment.

Underrepresentation of historically marginalized populations in clinical trials continues to threaten the validity of health intervention research. Evidence supports the merits of intercept and other proactive forms of recruitment for achieving more equitable representation. However, researchers also report lower retention and adherence to protocols among these populations, particularly in longitudinal studies. Few studies have compared recruitment methods for longitudinal randomized trials testing health interventions, with even fewer having done so for trials involving ecological momentary assessment (EMA). As intervention research integrates EMA and other data collection approaches requiring substantial participant effort, it is critical to better understand the effectiveness and implications of strategies to improve the representativeness of health research. This secondary data analysis compared outcomes of proactive and reactive recruitment strategies (mobile lab intercepts and internet/flyer advertising, respectively) in study inclusion, task completion, and retention within a 14-day randomized controlled trial that used EMA to evaluate cigarette package health messages. Proactive recruitment resulted in higher proportions of participants with low income and education, limited health literacy, and of diverse racial/ethnic makeup. However, this recruitment method also resulted in lower task completion, especially in the second week of the trial period, and lower retention, although group differences were not explained by participant sociodemographic characteristics targeted by inclusion efforts. We conclude that proactive recruitment via intercepts is an effective strategy for health intervention research that aims to include stakeholders from historically marginalized groups but that researchers and funders must recognize these methods require additional resources, considerations, and capacity to address non-trivial challenges to successful participation.

Perceptions of Arguments in Support of Policies to Reduce Sugary Drink Consumption Among Low-Income White, Black and Latinx Parents of Young Children.

PURPOSE: To test for racial/ethnic differences in perceived argument strength in favor of structural interventions to curb childhood obesity among lower-income parents of young children. DESIGN: Cross-sectional, self-report. SETTING: Online research panel, national sample of 1485 US adults in Fall 2019. PARTICIPANTS: Parents of children (age 0-5 years) with an annual income <$40,000, stratified by White, Black and/or Latinx race/ethnicity. MEASURES: SSB consumption, policy support, and strength of arguments in favor of marketing restrictions and a penny-per-ounce tax. ANALYSIS: Descriptive statistics, multivariable OLS models. RESULTS: Race/ethnicity was not a significant predictor of the perceived strength of a composite of marketing arguments (pBlack = 0.07; pLatinx = 0.10), however it was a significant predictor of the perceived strength of tax arguments (pBlack = 0.01; pLatinx = 0.01). Perceptions of strength of 12 of 35 discrete SSB tax arguments differed by race/ethnicity (p < .05). Arguments regarding industry targeting of Black children (marketing: pBlack < .001; pLatinx = .001; tax: pBlack < .001; pLatinx = .001), were particularly demonstrative of this difference. In contrast, arguments that these policies would provide support for parents (marketing: pBlack = 0.20; pLatinx = 0.84) and communities (tax: pBlack = 0.24; pLatinx = 0.58) were seen as strong arguments across groups. CONCLUSIONS: Black and Hispanic/Latinx parents may be more prepared to move toward SSB policy support than white parents. Emphasizing community benefits of policy may be effective in moving constituents toward policy support across groups.